Self-reported health and health care use in an ageing population in the Agincourt sub-district of rural South Africa

Abstract

Background

South Africa is experiencing a demographic and epidemiological transition with an increase in population aged 50 years and older and rising prevalence of non-communicable diseases. This, coupled with high HIV and tuberculosis prevalence, puts an already weak health service under greater strain.

Objective

To measure self-reported chronic health conditions and chronic disease risk factors, including smoking and alcohol use, and to establish their association with health care use in a rural South African population aged 50 years or older.

Methods

The Study on Global Ageing and Adult Health (SAGE), in collaboration with the INDEPTH Network and the World Health Organization, was implemented in the Agincourt sub-district in rural northeast South Africa where there is a long-standing health and socio-demographic surveillance system. Household-based interviews were conducted in a random sample of people aged 50 years and older. The interview included questions on self-reported health and health care use, and some physical measurements, including blood pressure and anthropometry.

Results

Four hundred and twenty-five individuals aged 50 years or older participated in the study. Musculoskeletal pain was the most prevalent self-reported condition (41.7%; 95% Confidence Interval [CI] 37.0–46.6) followed by hypertension (31.2%; 95% CI 26.8–35.9) and diabetes (6.1%; 95% CI 4.1–8.9). All self-reported conditions were significantly associated with low self-reported functionality and quality of life, 57% of participants had hypertension, including 44% of those who reported normal blood pressure. A large waist circumference and current alcohol consumption were associated with high risk of hypertension in men, whereas in women, old age, high waist–hip ratio, and less than 6 years of formal education were associated with high risk of hypertension. Only 45% of all participants reported accessing health care in the last 12 months. Those who reported higher use of the health facilities also reported lower levels of functioning and quality of life.

Conclusion

Self-reported chronic health conditions, especially hypertension, had a high prevalence in this population and were strongly associated with higher levels of health care use. The primary health care system in South Africa will need to provide care for people with non-communicable diseases.

• health care use
• older population
• self-reported health
• non-communicable disease
• WHODAS
• WHOQOL
• rural
• South Africa

A Corrigendum has been published for this paper. Please see http://www.globalhealthaction.net/index.php/gha/article/view/24080

A Corrigendum has been published for this paper. Please see http://www.globalhealthaction.net/index.php/gha/article/view/24080

Acknowledgements

We thank study participants and their families, members of the Agincourt HDSS field team, village and district authorities who made this work possible.

The study was funded by the National Institute of Aging of the National Institutes of Health, United States, and by the Wellcome Trust, United Kingdom (Grant number 058893/Z/99/A and 069683/Z/02/Z). It was carried out in collaboration with the World Health Organization and the INDEPTH Network and the support of the University of the Witwatersrand.

Conflicts of interest and funding

We declare that we have no conflicts of interest.

Notes

A Corrigendum has been published for this paper. Please see http://www.globalhealthaction.net/index.php/gha/article/view/24080